Question
How to effectively prevent pediatric seizures? What should be done in an emergency when seizures occur?
Answer
Hello: To prevent recurrence, some have suggested long-term medication, regardless of whether there is a fever, to take medication every day. However, the incidence of febrile seizures is very high, and severe sequelae are only a minority, so universal long-term medication would impose unnecessary burden on the majority of patients, and phenobarbital can also cause side effects such as drowsiness, restlessness, and hyperactivity. Therefore, the following indications for long-term medication have been proposed. (1) Complex febrile seizures. (2) Cases with risk factors, and after the second attack. Long-term medication can be selected from phenobarbital, valproate, sodium valproate, or carbamazepine. Emergency home management: 1. During an attack: (1) Acupuncture or thumb pressure: at the acupoint of Renzhong, Baihui, Hegu, and Shenmen. (2) Active cooling, ventilation and warmth while loosening clothing and bedding, using alcohol or warm water for bathing (neck side, armpit, groin). (3) Loosen the collar to keep the airway open. Lie on the side to prevent aspiration of vomit and secretions. If the child has not closed their jaw tightly yet, use a handkerchief or cloth pad folded into a strip or wrapped around the spoon handle to place between the upper and lower teeth to prevent biting the tongue. (4) Take antipyretic and antiseizure medication (aprotinin). (5) After simple emergency treatment, immediately send the child to the hospital for treatment. 2. For children with recurrent attacks or a family history of high fever seizures, pre-administer antipyretic and antiseizure agents at the beginning of fever or during vaccination. For some patients with high fever seizures, medication should be taken for 2-3 years or until they are 4-6 years old.